| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
171 |
155 |
$11K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
60 |
59 |
$3K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
16 |
16 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
32 |
32 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
18 |
18 |
$666.73 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
16 |
15 |
$449.04 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
15 |
14 |
$430.43 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
17 |
15 |
$282.15 |
| 71045 |
Radiologic examination, chest; single view |
80 |
70 |
$270.21 |
| 71046 |
Radiologic examination, chest; 2 views |
41 |
32 |
$247.04 |